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As Rotenberg leaves U, left behind is petition on Markingson case

The petition was launched a month ago after Mark Rotenberg rebuffed assertions that newly surfaced documents in the case of Dan Markingson were cause for alarm.

rotenberg portrait
Mark Rotenberg

It took just moments Monday for news broken by MinnPost’s Eric Black — that University of Minnesota General Counsel Mark Rotenberg had accepted a job at Johns Hopkins University — to be heard around the world.

As Black noted, as the university’s top attorney for more than 20 years, Rotenberg has been at the center of any number of controversies — especially those with legal ramifications. And so it is perhaps natural for his departure to occur while he’s in the headlines. 

Over the last month, Rotenberg’s name has become a household one in certain circles as a petition calling on Gov. Mark Dayton to order an investigation of the 2004 death of a severely mentally ill man gathered steam. Dan Markingson was enrolled in a U of M drug trial at the time he committed suicide.

Yesterday, as the news rocketed through the twittersphere, the petition was nearing 2,000 signatories. Among them are Richard Horton, the editor of The Lancet, three former editors of the New England Journal of Medicine and a veritable Who’s Who of top academics here and abroad.

Assertions rebuffed, petition launched

The petition was launched a month ago after Rotenberg rebuffed assertions that newly surfaced documents in the ongoing, complicated case of  Markingson were cause for alarm.

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St. Paul native Markingson stabbed himself to death in 2004 while enrolled in a U of M clinical trial of the antipsychotic Seroquel. His mother had objected vehemently and repeatedly to his participation, insisting that he was suicidal and incompetent to give informed consent. The researchers conducting the trial, U of M bioethicist Carl Elliott wrote, had financial incentives for enrolling patients.

U of M bioethics professor Carl Elliott has written extensively about the case, on his blog, Fear and Loathing in Bioethics, in national publications and in his most recent book, “White Coat, Black Hat: Adventures on the Dark Side of Medicine.”

After his first major piece was published in Mother Jones, a group of faculty asked the university Board of Regents to order an independent investigation. Two years ago after the regents declined, Rotenberg controversially addressed the U of M’s Academic Tenure and Freedom Committee, asking whether the faculty had a role in “addressing factually incorrect attacks on particular university faculty research activities?”  

The episode garnered headlines here and nationwide, many of them in academic publications concerned with protecting controversial faculty speech and research. One highlighted the case as an example of academic health centers’ “bare-knuckled litigation tactics” at numerous universities.

Issue of similar forms

In February, Elliott blogged that Markinson’s trial file, produced in response to a lawsuit filed by his mother, contained two slightly different versions of an “evaluation to consent” form documenting that a study coordinator had found Markinson competent to understand the implications of his consent. (The coordinator had been disciplined for forging doctors’ initials on records, among other irregularities.)

Elliott posted the two forms and asked if readers could help explain the puzzle. The families of several other trial participants wrote to say they had identical or virtually identical forms in their files; one consented to allow Elliott to post theirs.

“Most alarming of all the ‘answers’ supposedly given by the research subjects appear identical,” he wrote. “I find these documents so alarming that they demand an investigation. How many research subjects in the Department of Psychiatry have this same form in their charts?”

In response to questions about the forms posed by the Star Tribune, Rotenberg, said, “There is no evidence that any of [the consent forms] contained predetermined, photocopied answers.” He also suggested that the family with the duplicate form might have downloaded it from the Internet.

Elliott’s response: Release every patient’s evaluation to consent form, albeit with identifying information blacked out.

There’s much, much more, including copies of many of the major documents that have been released by various agencies in connection with the case.